UNIT 10 TRAINING AND DEVELOPMENT IN HOSPITALS

Objectives
At the end of this unit, the learners should be able to:
1. Define training and development;
2. State the need for training and development;
3. List the elements, objectives of training and development;
4. List benefits and advantages of training.
Structure
10.1 Introduction
10.2 Need and Rationale of Training
10.3 Definition of Training and Development
10.4 Symptoms for Training and Development
10.5 Elements of Training
10.6 Objectives of Training
10.7 Training, Development and Education
10.8 Benefits of Training
10.9 Advantages of Training and Development
10.10 Changing Facets of Training
10.11 Roles and Responsibilities for The Trainers
10.12 Summary
10.13 Key Words

10.1 INTRODUCTION

In the knowledge driven world of today, the pace of change is so fast that it even defies Moor’s
law. Even to stay at the same place, the organizations must run fast. Strategic advantage to the
organizations comes only from the core competences, which are developed by the individuals
working in it. Such levels of excellence can be achieved only by investing in people. Investment
must not confine to compensation only but must entail the inputs aimed at updating the skills
of the employees.

Thus, Training and Development (T & D) is an important phase in human resources

management. Employees may become obsolete or rustic if they do not update themselves with
new work methods, skills and knowledge about their work, the organization and the
environment. The entire organization may also become rustic and obsolete if it lacks a
systematic training program. Training is one such potion to cure the organizations of the
sluggishness, which may creep in because of the organizational inertia.

In modern healthcare environment, where there is so much of technological explosion need

for training of staff involved in patient care activities is essential to keep them in touch with
the new technological developments. Every Health care organization must have a systematic
training programme for the growth and development of its employees.

The term ‘training’ is used regarding teaching of specific skills, whereas the term
‘development’ denotes overall development of personality of the employees.

10.2 NEED AND RATIONALE OF TRAINING

Training is important, not only from the point of view of the organization, but also for the
employees. It gives them greater job security and an opportunity for career advancement. A
skill acquired through training is an asset for the organization and the employee. The benefits
of training stay for a very long time. Training can become obsolete only when there is a
complete elimination of the desired for that skill and knowledge, which may happen because
of the technological changes. In general terms, the need for training can arise because of the
following reasons.

Changing Technology
Technology is changing at a fast pace. Technological changes are changing the way in which
various treatment and investigation, surgeries are being carried out. All sophisticate biomedical
equipment’s are digital and automated. Newer machines are being used for automation of the
processes. Computers have made the controls very easy. Advances in information technology
have enabled greater degree of coordination between various patient units, departments and
between health care organizations spread far across the globe.

In order to keep themselves abreast with the changes, the employees must learn new techniques
to make use of advances in the technology and this will ensure improvement in the quality of
care. Training needs to be treated as a continuous process to update the employees in new
methods and procedures.

Demanding Customers
As the free markets become stronger, customers are becoming more and more demanding.
They are much more informed about the services, technology provided by the hospitals. They
have high expectations and information available to them on the click of the mouse, they
compare the services provided. Intensified competition forces the organizations to provide
better and better products and services to them.
Added to the customer conscious, their requirements keep on changing. In order to satisfy the
customers and to provide best of the quality of health care services, the skills of those
producing them need to be continuously improved through training.

Thrust on Productivity
In the competitive times, organizations cannot afford the extravaganza of lethargy. They must
be productive in order to survive and grow. Continuous improvement of the employees’ skills
is an essential requirement for maintaining high standards of productivity. Productivity in the
present times stems from knowledge, which must be relearned continuously.

Improved motivation
Training is a source of motivation for the employees as well. They find themselves more
updated while facing the challenging situations at job. Such skill development contributes to
their career development as well. Motivated employees have lesser turnover, providing an
organization with a stable work force, which has several advantages in the long run.

Accuracy of output
Trained workers handle their job better. They run their machines safely. They achieve greater
accuracy is whatever job they do. This reduces accidents in the organizations. Adherence to
accuracy infuses high standards of quality in the products and services, thus giving them a
competitive
edge in the difficult times. Quality reduces wastages and ensures better customer satisfaction.

Better Management
Training can be used as an effective tool of planning and control. It develops skills of the
workers for future and prepares them for promotion. It helps them in reducing the costs of
supervision, wastages and industrial accidents. It also helps increase productivity and quality.

10.3 DEFINITION OF TRAINING AND DEVELOPEMENT

Training is planned organizational efforts or activities concerned with helping an employee

acquire specific and immediately usable skills, knowledge, concepts, attitudes and behavior
to enable him or her perform efficiently and effectively on his present job.

Training, therefore, is related to improving upon the present job experience. It is concerned
with technical/manual skills to non-managerial staff.
According to Flippo, “Training is the act of increasing the knowledge and skills of an
employee for doing a particular job”.

Training involves the development of skills that are usually necessary to perform a specific
job. Its purpose is to achieve a change in the behavior of those trained and to enable them to
do their jobs better.

Training makes newly appointed employees fully productive in lesser time.

Training is equally necessary for the old employees whenever new machines and equipment
are introduced and/or there is a change in the techniques of doing the things.
Training is a continuous process and does not stop anywhere. The top management should
ensure that any training programme should attempt to bring about positive changes in the
knowledge, skills, and attitudes of the
Development, on the other hand, are planned activities which focus on increasing and
enlarging the capabilities of employees so that they can successfully handle greater and/or
assume higher positions in the organization’s hierarchy to better handle current
responsibilities.
Development usually focuses on improving the conceptual skills-the intellectual and abilities
needed to handle complex situations and do a better job (Mathis and Jackson, 1982; Klatt et
al, 1985). Development is therefore, not only “person-oriented”, but it also focuses on
supervisory and managerial personnel. This does not imply that these higher-level personnel
do not involve themselves in training activities. For example, “a manager may be trained in
public speaking so that the speeches he or she gives for the company will be better, just as a
stenographer may receive training to increase the rate of dictation that he or she can take”.
Training and development, however, are geared toward improving upon workers’
performance with the aim of achieving set organizational goals

10.4 SYMPTOMS FOR TRAINING AND DEVELOPMENT

There are usually certain signs in an organization, that serve as pointers to management that
training, and development activities should be engaged in to improve individual and
organizational performance. Some of these symptoms have been highlighted by Nwachukwu
(1988) to include:
• Lack of interest in one’s job
• Negative attitude to work
• Low productivity
• Tardiness
• Excessive absenteeism rate
• Excessive complaints (and excuses)
• High rejects or low-quality output
• High incidence of accidents
• Insubordination

10.5 ELEMENTS OF TRAINING

• There are three elements of training –

• Time
• Place
• Purpose
 TIME

PLACE PURPOSE

ELEMENTS
OF
TRAINING

Training without purpose is useless because nothing would be achieved out of it. The purpose
must be identified carefully and now there are many techniques, to be discussed in subsequent
lessons, available for establishing training needs. The purpose of training is to bring about
improvement in the performance of the human resources. It includes the learning of such
techniques as are required for the intelligence performance of definite tasks. It also
comprehends the ability to think clearly about problems arising out of the job and its
6responsibilities and to exercise sound judgement in making decisions affecting the work.
Lastly, it includes those mental attitudes and habits, which are covered under the general term
‘morale’.

After having identified the purpose of a training programme, its place must be decided i.e.
whether it must be on the job or off the job. If off the job, where a training programme should
be. Place would decide the choice of training method and influence its effectiveness.

The next element is the time. Training must be provided at the right time. A late training would
provide outdated knowledge, which would be useless for the employees. The timing has also
to be specified in physical terms, i.e. which month/week of the year and at what time of the
day. This can have a lot of ramifications in terms of the cost of training and its ultimate efficacy
in achieving the desired results.

10.6 OBJECTIVES OF TRAINING

The objectives of training can vary, depending upon many factors. The objectives depend on
the nature of the organization where training must be provided, the skills desired and the current
skill levels. It is difficult to draw generalizations of the objectives of training; still they can be
stated as under:
• To increase the knowledge of workers in doing specific jobs.
• To systematically impart new skills to the human resources so that they learn quickly.
 • To bring about change in the attitudes of the workers towards fellow workers,
supervisor and the organization.
• To improve the overall performance of the organization.
• To make the employees handle materials, machines and equipment efficiently and thus
to check wastage of time and resources.
• To reduce the number of accidents/adverse reactions by providing safety training to
employees.
• To prepare employees for higher jobs by developing advanced skills in them.

10.7 TRAINING, DEVELOPMENT AND EDUCATION

No longer do the organizations talk of training in isolation. It is usually addressed along with
development. While referring to the conjugation of the two processes, Dale Yoder has
observed “The use of the terms training and development in today’s employment setting is far
more appropriate than ‘training’ alone since human resources can exert their full potential
only when the learning process goes far beyond simple routine”.
Although the terms training and development are used together, they are often confused.
Training means learning the basic skills and knowledge necessary for a job or a group of
jobs. In other words, training is the act of increasing the knowledge for doing a job.
But development refers to the growth of an individual in all respects. An organization works
for the development of its executives or potential executives in order to enable them to be
more effective in performing the various functions of management. An executive
development programme aims at increasing the capacities of the individuals to achieve the
desired objectives.
Development is shown in Table

Training Development
1.Training means learning skills and Development refers to the growth
knowledge for doing a job and of an employee in all respects. It is
increases skills required for a job. more concerned with shaping the
. attitudes.

2. Training generally imparts 2. Development is more general in

specific skills to the employees nature and aims at overall growth
of the executives.
3. Training is concerned with Development builds up
maintaining and improving competences for future
current job performance. Thus, it has a performance and has a long-term
short-term perspective. perspective
.

4. Training is job centered in 4. Development is career

nature. centered in nature.
 .
5. The role of trainer or supervisor is
very important in training
5. All development is self-
development’ and the executive
has to be internally motivated for
the same.

Training and Education

Training is also different from education in the following respects:

• Training it is concerned with increasing knowledge and skills in doing a job. The major
burden of training falls upon the employer. But education is broader in scope. Its purpose is
not confined to developing the individuals, but it is concerned with increasing general
knowledge and understanding of total environment.

• Education generally refers to the formal learning in a school or a college, whereas training
is vocation oriented and is generally imparted at the workplace.

• Training usually has mere immediate utilitarian purpose than education.

10.8 BENEFITS OF TRAINING

The following paras highlight some of the potential benefits of training to the employees and
the employers

Benefits of Training to Employers

The employers invest in training because they reap several benefits out of the exercise, which
can be summed up as under:

Faster Learning of New Skills

Training helps the employers to reduce the learning time of their employees and achieve higher
standards of performance. The employees need not waste time in learning by observing others.
If a formal training programme exists in the organization, the qualified instructors will help the
new 11employees to acquire the skills and knowledge to do jobs quickly.

Increased Productivity
Training increases the skill of the new employee in while performing a job. An increased skill
level usually helps in increasing both quantity and quality of output. Training can be of great
help even to the existing employees. It helps them to increase their level of performance on
their present job assignments and prepares them for future assignments.
Standardization of Procedures
Training can help the standardization of operating procedures, which can be learnt by the
employees. Standardization of work procedures makes high levels of performance rule rather
than exception. Employees work intelligently and make fewer mistakes when they possess the
required know-how and skills.
Lesser Need for Supervision
As a generalization, it can be stated safely that trained employees need lesser supervision.
Training does not eliminate the need for supervision, but it reduces the need for detailed and
constant supervision. A well-trained employee can be self-reliant in his/her work because s/he
knows what to do and how to do. Under such situations, close supervision might not be
required.
Economy of Operations
Trained personnel will be able to make better and economical use of the materials and the
equipment and reduce wastage. Also, the trained employees reduce the rate of accidents and
damage to machinery and equipment. Such reductions can contribute to increased cost savings
and overall economy of operations.
Higher Morale
The morale of employees is increased if they are given proper training. A good training
programme molds employees’ attitudes towards organizational activities and generates better
cooperation and greater loyalty. With the help of training, dissatisfactions, complaints,
absenteeism and turnover can also be reduced among the employees. Thus, training helps in
building an efficient and co-operative work force.
Managerial Development
The top management can identify the talent, who can be groomed for handling positions of
responsibility in the organizations. Newer talent increases the productivity of the organizations.
By providing opportunity for self-development, employees put in their best effort to contribute
to the growth of the organization.
Benefits of Training to Employees
The employees are the ultimate link in an any organization, who carry out the operations.
Training can help them in several ways, as mentioned below:
Increasing Confidence
Training creates a feeling of confidence in the minds of employees, who feel comfortable
while handling newer challenges. It gives a feeling of safety and security to them at the
workplace.
New Skills
Training develops skills, which serves as a valuable personal asset of a worker. It remains
permanently with the worker himself.

Career Advancement
The managers can develop their skills to take up higher challenges and work in newer job
dimensions. Such an exercise leads to the career development of the employees, who can move
up the corporate hierarchy faster.
Higher Earnings
Higher earnings are a consequence of career development. A highly trained employee can
command high salary in the job market and feel more contended.
Resilience to Change
In the fast-changing times of today, training develops adaptability among workers. The
employees feel motivated to work under newer circumstances and they do not feel threatened
or resist any change. Such adaptability is essential for survival and growth of an organization
in the present times.
Increased Safety
Trained workers handle the machines safely. They also know the use of various safely devices
in the factory, thus, they are less prone to accidents. It can be concluded that considering
several benefits, training is an important activity, which should be taken very seriously by the
employees as well as the employers.

10.9 ADVANTAGES OF TRAINING AND DEVELOPMENT

The advantages of employee training and development can be summarized thus:

• Increased knowledge, skills and the development of positive behavior and attitude to
work.
• Increased organizational productivity and quality products.
• Improved worker’s morale
• Reduced turnover rate among workers.
• Brings about sense of belongingness among employees and reduces the rate of
absenteeism.
• Brings about better coordination of both human and non-human resources within the
organization as it helps to save supervisor’s time of supervision.

10.10 CHANGING FACETS OF TRAINING

The present time of rapid change has its influence on training also. Lynton and Pareek have
identified the following salient changes, that have occurred in training in last thirty years:

• Training has changed from training individuals to training teams of people, comprising
of members across the hierarchies.
• Training has acquired an inter-group learning character.
• Training is finding itself linked with the organizational development process. It is a part
of a higher-end corporate relearning exercise.
• Socio-technical systems are influencing the training processes in organizations.
• Target audience of audience is also undergoing a compositional change. There are a
greater number of females and people from diverse ethnic groups and castes working
in the organizations. This creates diversity in the training activity as well.
• Technologies, government and markets are undergoing a rapid change. (This issue is
not being addressed to in detail here as it requires a detailed discussion, which is usually
included in the paper on business environment).
• Training extends beyond employees and includes clients, suppliers, publics as well,
making a learning organization into a learning system. The changes must be learnt by
 the organizations to ensure effectiveness of training exercise. The roles, responsibilities
of the trainers are undergoing changes, and are discussed hereunder.
10.11 ROLES AND RESPONSIBILITIES FOR THE TRAINERS

A trainer has many roles to play in order to make any training effective. Unlike in education,
where the guru acted as a friend, philosopher and a guide, the relationship between a trainee
and a trainer is more professional. Still, a trainer must wear many hats. There are many
classifications of a trainer’s role, which can be stated as follows.
• The trainer
• The provider
• The consultant
• The innovator
• The manager

The Trainer
A trainer’s role is primarily concerned with actual direct training. It is a role that involves the
trainer in helping people to learn, providing feedback about their learning and adopting course
designs to meet trainees’ needs. The trainer’s role may involve classroom teaching and
instruction, laboratory work, small group work, supervision of individual project work and all
those activities that directly influence immediate learning experiences. In effect, the trainer is
a learning specialist.
The Provider
This training role relates to the design, maintenance and delivery of training programmes. It
involves training-needs analysis; setting objectives; designing courses; choosing appropriate
methods; testing out and evaluating courses or training activities; and helping trainers to deliver
the training.
The Consultant
As a consultant, a trainer is primarily concerned with analyzing business problems and
assessing/recommending solutions, some of which may require training. It may involve
some elements of the provider role but specifically concentrates on
• liaising with line managers
• identifying their performance problems
• advising on possible training solutions (where appropriate)
• working with providers and/or trainers to establish training programmes;
• advising training managers (where the roles are separated) on training goals:
and policies
• ensuring evaluation takes place and the results are used.

The Innovator
As an innovator, a trainer is concerned with helping the organizations to manage the change
effectively and to solve performance problems. It involves:
• Working with managers at senior/middle levels.
• Providing support and help to managers in coping with change.
• Identifying where seminars and workshops can be a useful means of educating managers for
change.
• Facilitating change; identifying the real sources of power in the organization and linking with
these to help bring about change.
• Advising the training function on how it can best help in the change process.
The Manager
A manager’s role in training is primarily concerned with planning, organizing, controlling
and developing the training and development activity or function. It involves the following
functions:
• Setting training goals, policies and plans.
• Liaising with other departments and with senior managers about the contribution training.
• Setting training goals, policies and plans.
• Liaising with other departments and with senior managers about the contribution training
can and should make to improving performance.
• Ensuring that appropriate training activities are designed, developed, delivered and
evaluated.
• Acquiring and developing training staff; establishing effective lines of authority and
communication within the training function.
• Acquiring and effectively using non-staff resources.
• Monitoring quality standards and controlling activities against a total training plan.
10.12 SUMMARY
Quality healthcare delivery requires many components including a qualified labor force to
work in hospitals. A shortage of workers creates a stress on healthcare delivery systems and
undermines healthcare quality. Hospitals, today, have realized the need to shed their image of
a cluttered and chaotic place. More health and quality-conscious Indian customers and
international patients are on the lookout for cheaper yet superior healthcare facilities, which in
turn have given a new dimension to the concept of care and indirectly to the training and
development scenario. "Hospitals are being compared to hotels and airlines, and the customer
is more demanding and expects nothing but warm and hospitable staff,” No more do patients
just flock to hospitals for treatment. "To fulfill this demand, training and development has
gained crucial importance,

10.13 KEY WORDS

Training: -is the act of increasing the knowledge and skills of an employee for doing a job.
Development: - Development refers to the growth of an individual in all respects. An
organization works for the development of its executives or potential executives in order to
enable them to be more effective in performing the various functions of management.
Education
Education is formal learning and is concerned with increasing general knowledge and
understanding of total environment.